Field-Based RN Case Manager — Impactful Community Care

IntelliResume; Field (NM); On-site; USD 65,000 - 90,000; Full time

Job summary

CVS Health is seeking a Field-based Case Manager RN to assess, plan, implement and coordinate care for members in the community, combining telephonic and face-to-face visits. The role emphasizes clinical judgment to reduce risk factors and ensure appropriate benefit plan eligibility, with a strong focus on member engagement.

You will travel 50%+ in the western region, reside in West Virginia, and work full-time Monday–Friday 8am-5pm, conducting visits, reviewing claims, and collaborating with

Qualifications

• 5+ years of clinical practice experience.
• 2+ years of experience with personal computers and MS Office Suite.

Responsibilities

• Conduct face-to-face member visits.
• Evaluate member's needs and benefit plan eligibility using clinical tools.
• Apply clinical judgment to reduce risk factors and barriers.
• Assess information from various sources for co-morbid conditions.
• Review prior claims to impact current case management.
• Assess the need for referrals to clinical resources.
• Consult with management to overcome barriers in meeting goals.
• Utilize case management processes in compliance with policies.
• Ensure maximum member engagement through effective interviewing.

Skills

Clinical practice

MS Office

Education

Associate degree in nursing

Tools

MS Office Suite

Job description

CVS Health is seeking a Field-based Case Manager RN to assess, plan, implement and coordinate care for members in the community, combining telephonic and face-to-face visits. The role emphasizes clinical judgment to reduce risk factors and ensure appropriate benefit plan eligibility, with a strong focus on member engagement.

You will travel 50%+ in the western region, reside in West Virginia, and work full-time Monday–Friday 8am-5pm, conducting visits, reviewing claims, and collaborating with